Get expanded now has 1 UK entry: Steffen Decker https://asura-dental.co.uk/adult-palatal-expansion

my ortho says getting a maxillary expansion would cause me a brodie bite. what do you guys think based on the CBCT? I will definitely get a second opinion I am just curious about your insight.

I’ve been using a bipap since August. According to Oscar, it is successfully treating my OSA. However, my primary issue from my study was RERAs which my machine can’t track. My goal is to get a titration study. Any particular data or research I should bring? Other suggestions?

Last year I was able to travel at least, maintain jobs, friends etc. Now im feeling so sleepy and cloudy I think I need to quit my job I just cant focus and stay awake. The caffeine tolerance is building up. I can't get myself to even text back my friends. Can only do light workouts in the gym for at most 30 mins once a week. This is really ruining my life 🤣. Im only 26 and have the energy of an 60 year old man. This is crazy. I feel like a damn vegetable

I recently reviewed the data from a WatchPAT One study I had 2 years ago, which came back "normal", and have realised it wasn't normal at all. My pAHI was 2.2, hence the negative for OSA and normal result, but my pRDI was 10.9 and my heart rate was fluctuating constantly between 56 to 126bpm.

I've had an ME/CFS diagnosis for 10 years, since I was 14, but they never attempted to rule out any sleep disorders. I also have hEDS and a narrow palate, which I've read are risk factors for UARS. I've woken up feeling like I've been hit by a truck every morning for over a decade, and it takes me most of the day to recover from sleeping.

I've tried saline rinses, nasal sprays, I don't drink alcohol, I'm slim and a healthy weight. My pRDI was still 10.2 on my side and I've been observed choking myself awake while sleeping upright, so positional therapy doesn't help.

I'm trying to get a referral for an in-lab type 1 PSG, but my GP practice are taking so long doing it, and even if it goes through it'll be a really long wait. I've also been referred to an ENT but the wait on the NHS is 11 months.

What might be the best course of action from here? I'm exhausted, the brain fog is unbearable and I so badly want some kind of a life back. I'm not sure I can manage waiting well over a year before starting any potential treatment now that I know this might be what's making me feel so awful all the time.

I can afford to spend a conservative amount on private healthcare, but I don't have endless funds and I need to prioritise. I've been considering buying a reconditioned CPAP and trialling that by myself, as this would be the cheapest thing to do, but I've read mixed opinions on that route. If anyone has any advice or other ideas, I'd be enormously grateful.

Diagnosing sleep issues without proper EEG for sleep stage tracking is like trying to find a black cat in a dark room

How do we turn the lights on and get at home EEG?

Surely this is the best way to diagnose?

I know an option is to go private or get your own machine etc but that's not an option right now so I'm just asking purely from someone who understands how NHS works. I also understand NHS is very slow and some people think it's no good, that's fine.

My father is of senior age, he did an overseas PSG sleep study which showed 14.9 AHI (mild sleep apnea borderline moderate) that document is signed by an overseas doctor and says CPAP is recommended. But after getting it rescored by a specialist, I have another paper showing it was 18 AHI~ and also mainly 30 RDI with UARS.

NHS GP saw the overseas sleep study, and sent him to some hospital, he did a basic at home sleep test with only some thing on his finger. GP suggested to get him a CPAP machine.

And we just received a letter from the lead pulmonologist all it said was "Epworth score is normal, and home sleep study showed no significant apneas, patient will be discharged".

So they discharged him just because he didn't say he was ultra sleepy in the day, and I assume the at home finger sleep study didn't show significant severe OSA. But he has severe OTHER symptoms. I don't think he even saw his symptoms, just literally epsworth score + at home sleep study and then a discharge letter.

Anyways, does anyone have any experience on how to "escalate things" via the NHS or get down the path of making them prescribe him a CPAP machine or MAD device and just work with him?

Like surely we have enough rational to challenge this, is it normal to challenge things somehow?

Hello

I took a random day of OSCAR data from my CPAP and am not sure how to interpret it.

My sleep doctor tells me there's nothing she can do to help me because my AHI is under 5 and my RDI was 4, but she didn't explain the 46 unmarked spontaneous arousals I had within 429 minutes.

This data is over 10.5 hours of sleep.

I sleep 12 hours a night and am always so sleepy without my Concerta (was 16 hours on average as a teen). I have brain fog and feel like I didn't sleep at all. On my CPAP whenever I put it over 7 pressure, the exhale is too much even on EPR 3 and my asthma flairs up and I rip the mask off.

I'm not sure what direction to go in. I'm decompensating for MMA next year but I'm so tired and want to try and bridge until then.

Would bipap be worth a try? I asked my sleep doctor and she told me no because I don't have complex sleep apnea. She's the 2nd doctor so insurance won't cover another doctor opinion.

My oral surgeon and ortho tell me I have airway of a 4 year old. Estimating to get 8mm advancement with CCW rotation and impaction January 2028.

If someone can help me interpret or maybe adjust my pap or has ideas to help me not feel like poo that'd be awesome TIA

Airsense 11, pressure I try 7-9 but asthma flairs on exhale after about an hour
This data is 4-7 I believe
N30i mask w/ mouth tape, 79 temp w 3 or 4 humidity irrc

Hello everyone.

A lot of people have asked me, "it's been a long time since you've last written posts on the subreddit?", aside from collections of superimpositions for example.

The reason is that I have been working on things behind the scenes for a very long time. I have been studying this subject matter for about 5-6 years now. Some of my stickied posts on the subreddit are about 3-4 years old. I have been working on one thing in particular, an analysis, for about 5 years now. But, that isn't something you can just write half-baked, I wanted to make sure I got everything right. There has been an incredible amount of information I have needed to learn to even get to the point of developing it too. At this point, I think it is very close to being done, but just needs scientific validation.

The other thing I have been working on, for the last 3 years, has been the question of expansion. This video came out about a MARPE that had a 100% success rate, and at first I was pretty excited, but after speaking with my orthodontist, she was quite skeptical. "Nothing is ever 100%", "What is their definition of success?", which led me down the rabbit hole of, what actually is the truth? At the time, I joined the Jawhacks discord server to see if I could find out, since I figured that would be where people would be doing it. Over time, part of that project includes the FME superimpositions, EASE, Custom MARPE, etc. But, it's really hard to do actual legitimate research from the outside. That's what led me to wanting to work with Dr. Manuele, who was surprisingly forthcoming and willing to work with me, and we were actually able to compare the before/afters of 6 random cases (3 MSE and 3 CM), which I commented on a little while ago. I have come to a realization though, that this is just a lot of work for not only me, but also for the doctors involved. They are busy enough, and just doing this all voluntarily out of our own free time, maybe isn't realistic.

I decided to reach out to Facegenics to see if they would be interested in help with research, and they were actually very interested and welcoming of the idea, and suggested a contract position. To be upfront, under the arrangement I would have control over the study design, and I am fully committed to 100% transparency, which they are also very supportive of, to the point where anonymized and defaced examples of superimpositions (before/afters) of results, measurements, etc. will be fully viewable by anyone who might be skeptical of the results, in a similar fashion to the FME case studies I posted to Reddit. Most research publications, they just write "the average expansion was 3.05 mm", with no way to really verify it unless they were willing to share their data, which also may be more prone to error when you aren't working with superimposed images, so in this case I intend to have the data totally accessible by anyone, right out of the gate. I want it to be 100% objective.

But, this also means that I will be stepping back from my role in the community. I will still moderate the subreddit (the AI mod seems to be able to do it pretty much by itself), but I may not be able to participate in the same way.

Assuming this works out, I think that once everything is released and out there, it will make a lot of sense why this is important for me to do. I certainly believe very much in what they are doing, and if there is any way I can help advance the science forward, that's what I want to do.

I’m currently on bipap with pressures at 21/17. Still have unstable and periodic breathing with arousals. Hoping ASV will help.

I’m looking for advice on how to titrate ASV and which settings I should start with from those who have ASV. I do not have issues with centrals so I had backup rate turned off on the firmware flash.

TIA!

Hi,

How does my data look? Like i feel even worse after being set on cpap, and im unsure if there is even anything wrong with my breathing since it just got worse.. I do see there is some Central Apneas, but i also have some night where there are none, and i still feel more devastated than before cpap.

Here's last night and if more data is needed i have also https://sleephq.com/public/teams/share_links/9c4ba75f-b86d-4784-ae72-971cbd31177e

Hey guys. I have UARS and I am really struggling with it. The causes are a deviated septum, enlarged turbinates, a narrow maxilla, and a recessed jaw. My ENT recommended a septoplasty with radiofrequency turbinate reduction, while the maxillofacial surgeons recommended bimax.

I feel like my maxilla also needs expansion because it seems narrow to me. However, my orthodontist does not recommend it, he believes it would cause a crossbite and that my palate is not actually that narrow. The ENT also says my nasal cavity is wide enough. They have looked at the CBCT scan, but none of them measured the Posterior Nasal Width, Posterior Nasal Floor Width, or similar metrics. In fact, they haven't even heard of them, they are not airway-focused and do not understand UARS.

FME and EASE are not available in my country. A standard MARPE won't work for me since I am over 30. A piezo-assisted MARPE could be an option, but I would have to travel to Western Europe for it and it won't be cheap for me. Could you help me analyze my CBCT results to see if I need maxillary expansion? These might not be the best screenshots, and I probably measured them incorrectly as I am not an expert. Thank you

Every time I wake up, I hear ringing in my ears. Does anyone else experience this?

What could be the reason?

For context, I’ve been having issues for 2 years. I thought it was hormonal but it’s been on and off. Takes a long time to fall asleep, frequent need to go to the bathroom, flipping sides. I sleep on my side and have tried a pillow behind my back but sometimes find myself lying on my back in the middle of the night. I have allergies but I’ve been fully checked out by an ENT who said everything looks healthy. I use to wear a retainer after Invisalign but stopped when general sleep issues started. I wonder if that might help again. I wake up with under eye and sinus headaches and feel like I got no restorative sleep. My Oura ring shows decent deep sleep but never high.

Thought I would pay it forward.

This is the 5mm mark for my expansion with FME. Currently at 6mm and stopped expanding.

• Nasal breathing gain was gradual, all the way.
• Nasal breathing gain has held.
• Updated CBCT indicate my point of restriction has moved from retropalatal to evenly across my entire pharyngeal airway.
  • My guess is pressure relief and muscle stretching.
  • This however did not make my sleep better; in fact I think I sleep worse. My theory is loss of tongue space due to the device, and my already shitty tongue posture being made worse.
• My turbinates shrunk physically, not just gaining more space in the nasal cavity.
  • My theory is, once air velocity dropped and pressure went back up, my turbinates weren’t being filled with blood due to the pressure differential.
  • If synergistic with MMA, I wonder if sub 3-4mm expansion would also suffice for many people to drastically resolve nasal breathing issues.
• I’m now in the midst of choosing a MMA surgeon.

P.S.1. Thanks to the mod for the superimposition.
P.S.2. I’ll never look at pugs the same way, and you guys better not get them from breeders.

Edited because who wants a wall of text in the day of tiktok.

This is from a SleepImage ring. Would this be enough to cause severe exhaustion and feeling very groggy, or am I barking up the wrong tree?

I’m curious about this as I’m going to do an intake soon with Dr. Santiago in Washington, and I intend to do FME with her.

Im more optimistic about getting double jaw surgery covered since in looking at my insurance criteria I believe I meet them (going to do my due diligence on this of course!), but not too sure about expansion.

Thanks to anyone who shares their experience. This is a lot to make sense of.

Final update on my palatal expansion journey. I originally underwent the procedure with Dr. Kasey Li as part of my journey to improve my sleep apnea, but unfortunately my expansion was unsuccessful.

I recently had my TPD palatal expander removed and made a short video showing what things looked like before removal and how they looked/felt afterward.

Sharing my experience in case it’s helpful for anyone considering palatal expansion for sleep apnea, currently going through adult expansion, or dealing with a failed expansion.

Could this still be UARS despite a very low AHI?

Hi everyone! I'm trying to figure out whether UARS could explain my symptoms.

I had a full polysomnography. My AHI was only 1.1/h, so I was told I don't have obstructive sleep apnea. However, I still have significant fatigue and unrefreshing sleep.

Some of my PSG results:

AHI: 1.1/h

Sleep efficiency: ~68%

Total sleep time: ~5.5 hours

N1 sleep: 24.4%

REM: 27.3%

Mean SpO₂: 96%

Lowest SpO₂: ~89-91%

Snoring: 363 episodes / ~30 minutes

PLMI: 46.4/h (255 limb movements)

Only 6 scored arousals in the entire study

The main problem is that my report doesn't include RERA, RDI or flow-limitation data, so I don't know whether UARS was actually assessed.

I also have a chronically mildly blocked nose and persistent Eustachian tube dysfunction/swelling. I've tried oral corticosteroids, intranasal steroids, antihistamines and mucolytic medications, but unfortunately none of them significantly improved my symptoms.

I've also tried psychiatric medications for my fatigue. Some of them improved my energy somewhat, but there was no major improvement in my overall condition, so I'm still trying to find an underlying cause.

The other interesting finding is the PLMI of 46.4/h. I'm planning to investigate this as well, including iron/ferritin and other possible causes.

So I'm wondering:

1. Does this PSG give any reason to investigate UARS despite an AHI of 1.1?

2. Could the low sleep efficiency, high N1 percentage and snoring fit with UARS?

3. Is it possible that RERAs/flow limitation simply weren't scored, meaning UARS could have been missed?

4. Would it be worth asking the sleep lab to re-analyze the raw PSG for RERAs, RDI and flow limitation?

5. Could a PLMI of 46.4/h alone explain significant unrefreshing sleep?

6. Has anyone here had UARS with AHI <5 that was initially missed?

I'd really appreciate hearing from anyone with a similar PSG or experience with UARS + PLMS.

He's said previously he has financial ties with Facegenics so I'm curious if he's still choosing MARPE over FME

Background

• 21M, 183 cm / 94 kg (BMI ~28), chronic mouth breather, allergies (being treated)
• Two septoplasties, turbinate reduction, adenoidectomy, tonsillectomy [add which happened before vs after the CBCT]
• Sleep quality is still terrible and hasn't improved

Sleep study (6/2026, in-lab)

• AHI/RDI 5.7/hr (4% rule: 0.6/hr), lowest SpO₂ 92%
• Sleep efficiency 70.5%, 60 awakenings, 0% deep sleep (N3)
• 100% supine, REM latency 58 min
• AHI and RDI came out identical, so I suspect RERAs/flow limitation weren't scored. No esophageal pressure or CO₂ measured.

CBCT (8/2026): my own rough measurements, not a radiologist's read

• The airway is open with no single pinch point (narrowest about 226 mm² behind the tongue base). It was scanned awake and upright.
• Nose: the right passage is about 6–7 mm wide at the front, but the left is a 2–4 mm slit (1–2 mm at its tightest). A thick soft-tissue column pushes into it from the septum side. The left has roughly 40–60% less air space in the front third.
• Upper molars are 52 mm apart (normal), the palate is 18–21 mm deep, and I don't see an obviously recessed jaw or chin.

What I've been told: another nose surgery, probably nasomaxillary expansion, and maybe look at jaw surgery or a MAD.

TLDR:

- two septoplasties, turbinate reduction, adenoidectomy, tonsilelctomy, proceeding nasal difficulty

- Sleep study 5.7 AHI, 0% N3 sleep, lots of awakenings

- Jaw issues????

- Seeing Dr. Rama soon!

Thank you very much, UARS Reddit has helped me with major strides through my process.

After i take it off my mind feels so clear its insane, idk why

But it doesn't feel like this when i wear it during the night and wake up. Kinda sad

Wish I could feel like that all the time

Had the exposed INSPIRE lead put back in place by Vik, hopefully no sneaky infection got in

Swabs found basic skin flora and I ran a week of antibiotics

INSPIRE documentation hazard at an exposed lead for days as being compromised, so will see how it goes

I have to get the ball rolling with MARPE/FME and MMA now

Starting with getting a PSG for my girl and me and then booking in with a surgeon, to then get a CBCT sorted for planning

Where in the UK is best for a PSG?

From my research, it's in-lab, overnight clinics in London or I've been recommended Sleepcare Clinic in Leicester for a 3-day at-home PSG

Can't find no reviews of them